OSTEOARTHRITIS AND AGING

骨关节炎(OA)是老年人最常见的关节炎， 是活动受限、身体残疾和健康的主要原因 老年人的服务利用情况。作为正在进行的办公自动化研究的一部分 在巴尔的摩老龄化纵向研究(BLSA)中，为了测试 关于遗传标记可能与基因表达有关的假设 骨关节炎，尤其是泛发性(多关节)骨关节炎，我们研究了 人类aggrecan基因多态(AT)等位基因间的关联 74名高加索人中至少发现11个等位基因)和双侧手膝骨关节炎 60岁及以上的男性。从获得的成纤维细胞样本中培养出DNA 这些受试者接受了双侧手部和膝部X光检查， 用聚合酶链式反应和/或Southern分析来分析是否存在等位基因 人类聚集素基因。根据年龄和体重指数进行调整后 (BMI)，似乎等位基因#5的存在与 双侧手性骨性关节炎的风险增加(优势比[OR]5.3，p=0.007)，但不是 双侧膝骨性关节炎，这将是第一次与 人类聚集素基因多态性与骨性关节炎我们目前正在分析 在女性身上也有几个样本。我们还考察了 545名高加索男性和350名高加索男性膝关节骨性关节炎的手术治疗 女人。36名受试者在X光检查前做过膝关节手术。多变量 模特，根据年龄、BMI、性别和吸烟状况进行调整 X光显示膝关节OA AS的优势比(OR[95%CI])增加 按凯尔格伦-劳伦斯(KL)量表(108.4[12.8,916.8])测量， 骨赘分级(15.4[5.9，39.8])和关节间隙狭窄(JSN)(12.5 [5.5，28.3])。膝关节手术与膝骨性关节炎密切相关， 尽管手术的适应症可能是一个贡献或 混杂因素。我们还检查了全膝关节的预测因素。 177名高加索人(男性126名，女性51名)接受了替代手术(TKR)， 谁有明确的膝盖骨关节炎，并完全症状 在X光检查时进行问卷调查。其中11名受试者的TKR为1-8 做了多年的膝部X光检查。多变量模型，根据年龄进行调整， X光检查时的体重指数、性别和吸烟状况 有以下症状的受试者发生TKR的几率增加：疼痛(14.0[2.8， 68.9])、吉隆坡2-4级(23.4[4，4,114.2])和联合军种(19.5[2.3,162.0])，以及 硬化(19.2[4.4，82.8])。中重度膝骨性关节炎，关节间隙 狭窄和软骨下硬化症，并伴有膝部疼痛，都是 全膝关节置换术的预测。除上述已完成的工作外 工作，自1996年1月以来，我们一直在收集膝盖X光照片 所有40岁及以上的BLSA受试者，以增加我们有限的 收集膝关节纵向X光数据，并提供更多 关于非洲裔美国人参与者的横截面和基线数据 BLSA。

Osteoarthritis (OA) is the most common form of arthritis in the elderly, and is a major cause of activity limitation, physical disability and health services utilization in the elderly. As part of the ongoing studies of OA in the Baltimore Longitudinal Study of Aging (BLSA), in order to test the hypothesis that genetic markers may be implicated in the expression of OA, especially generalized (polyarticular) OA, we have examined the association between alleles of the polymorphic human aggrecan gene (at least 11 alleles identified) and bilateral hand and knee OA in 74 Caucasian men aged 60 and over. DNA grown from fibroblast samples obtained from these subjects, who had bilateral hand and knee x-rays, has been analyzed by PCR and/or Southern analysis for the presence of alleles of the human aggrecan gene. After adjustment for age and body mass index (BMI), it appears that the presence of allele#5 is associated with increased odds of bilateral hand OA (Odds ratio [OR] 5.3, p=0.007), but not with bilateral knee OA, which would be the first association between a human aggrecan gene polymorphism and OA. We are currently analyzing several more samples in women as well. We also examined the history of knee surgery with knee OA in 545 Caucasian men and 350 Caucasian women. 36 subjects had knee surgery prior to the x-ray. Multivariate models, adjusting for age, BMI, gender and smoking status at the time of x-ray, demonstrated increased odds ratios (OR[95%CI]) of knee OA as measured on the Kellgren-Lawrence (KL) scale (108.4 [12.8, 916.8]), the Osteophyte scale (15.4 [5.9, 39.8]), and Joint space narrowing (JSN) (12.5 [5.5, 28.3]). Knee surgery is significantly associated with knee OA, although the indication for the surgery may be a contributing or confounding factor. We also examined factors predictive of total knee replacement surgery (TKR) in 177 Caucasians (126 men and 51 women), who had definite radiographic knee OA, and completed symptoms questionnaires at the time of x-ray. 11 of the subjects had a TKR 1-8 years following the knee x-ray. Multivariate models, adjusting for age, BMI, gender and smoking status at the time of the x-ray, demonstrated increased odds of TKR among subjects with the following: Pain (14.0 [2.8, 68.9]), KL grades 2-4 (23.4 [4,4, 114.2]), and JSN (19.5 [2.3, 162.0]), and Sclerosis (19.2 [4.4, 82.8). Moderate-to-severe knee OA, joint space narrowing, and subchondral sclerosis, with concurrent knee pain, are all predictive of total knee replacement. In addition to the above completed work, since January 1996, we have been collecting knee radiographs on all BLSA subjects aged 40 and over, in order to add to our limited collection of longitudinal knee x-ray data, and to provide more cross-sectional and baseline data on African American participants in the BLSA.